Growing Burden of Non-Communicable Diseases in the Emerging Health Markets: The Case of BRICS

摘要

The ultimate demographic transition consisting of ascending portion of elderly, falling fertility rates, and bold growth of median age within contemporary nations became broadly recognized as population aging (4). Most of this transformation of morbidity and mortality structure happened in rich industrial countries of Western Europe, North America, and Japan many decades ago. The same pattern of population aging associated with huge incidence and prevalence rates of major non-communicable diseases repeated on wider scale much later in developing countries. The worldwide transformation of public health landscape to the large extent is attributable to the accelerated pace of globalization after the end of Cold War era (5). Particularly interesting, current developments belong to the economies responsible for most of global growth that are recognized as the emerging markets. The countries whose reshaped structure of morbidity is most likely to affect global health in the future are definitely the BRICS [Brazil (6), Russia, India, China, South Africa] (7). BRICS’s far extended long-term influence in health arena worldwide will be related to their mammoth sized populations. Their increased domestic demand for medical technologies and medicines is already shaping investment strategies of major pharmaceutical and medicinal device industries. Another significant issue is their bold foreign medical assistance programs particularly targeted for emerging markets of Sudanese Africa, Latin America, Central and South East Asia (8). These leading countries are closely followed by a set of smaller scale economies mostly marked as N-11 (Bangladesh, Egypt, Indonesia, Iran, South Korea, Mexico, Nigeria, Pakistan, the Philippines, Turkey, and Vietnam) (9). Very similar process is simultaneously taking place in dynamically developing Southern (10) and South-East Asian (11), Latin American, Eastern European (12), and Arab speaking MENA region (13). Eradication of poverty currently taking place in these regions is coupled with changed dietary habits (14) (higher salt and fat and lower carbohydrate intake), wide spread tobacco abuse, and sedentary life styles (15). The mentioned factors contributing to the growing burden of non-communicable diseases. It became obvious that contribution of emerging markets and Third World countries to the global economic burden of NCDs will grow further. It will, highly, likely, soon have greater share than the one of established mature market economies (16). As basic assumption of most forecasts remains the fact that such growth will be dominated by developments in China (17) and India (18). High toll of this unfortunate change for developing countries is coupled impact of communicable and non-communicable diseases (19). At the same time, many national health systems throughout Asia and beyond expose poor responsiveness to the NCDs related population needs. There seems to be serious barriers in access to medical care and its affordability to the ordinary citizens.